Charcot arthropathy risk elevation in the obese diabetic population.
OBJECTIVE
To examine the association of obesity, peripheral neuropathy, and other risk factors with the Charcot arthropathy incidence rate in a large diabetic population.


METHODS
The Department of Veterans Affairs inpatient and outpatient administrative datasets were used to identify persons with diabetes in 2003. Logistic regressions were used to model the likelihood of a person developing Charcot arthropathy as a function of individual characteristics, obesity, peripheral neuropathy, diabetic control, and comorbidities.


RESULTS
Of Veterans Affairs users with diabetes, 652 (0.12%) were newly diagnosed with Charcot arthropathy in 2003. Compared with persons without obesity or peripheral neuropathy, those with obesity alone were approximately 59% more likely, those with neuropathy alone were 14 times more likely, and those with both obesity and neuropathy were 21 times more likely to develop Charcot arthropathy. Ages 55 to 64 years, diabetes duration 6 years or more, hemoglobin-A1c 7% or more, renal failure, arthritis, and deficiency anemia also were associated with an increased incidence of Charcot arthropathy.


CONCLUSIONS
Obesity is significantly associated with an increased incidence of Charcot arthropathy independently of other risk factors. When obesity is combined with neuropathy, the Charcot arthropathy incidence rate increases multiplicatively. Prevention and detection of Charcot arthropathy should take the interaction between obesity and neuropathy into consideration.
Stuck
Rodney M
RM
Surgical Service, Edward Hines Jr VA Hospital, Hines, IL 60141-3030, USA.
Sohn
Min-Woong
MW
Budiman-Mak
Elly
E
Lee
Todd A
TA
Weiss
Kevin B
KB
D000368:Aged; D000369:Aged, 80 and over; D001177:Arthropathy, Neurogenic / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000453:epidemiology*; D005260:Female; D005534:Foot Diseases / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data